Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy
| Autor: | Hiroshi Tajima, Ryohei Nomura, Hiroki Sunagawa, Manabu Watanabe, Toshiki Rikiyama, Yusuke Kumamoto, Takanori Morikawa, Noriaki Kameyama, Tatsuhiro Kin, Hidejiro Urakami, Akiko Umezawa, Junya Fukuzawa, Goro Honda, Ryota Higuchi, Hidenori Haruta, Hisashi Ikoma, Teijiro Hirashita, Atsushi Miyoshi, Masaharu Higashida, Yuta Abe, Masahiro Yoshida, Yukio Iwashita, Yasuji Seyama, Ryuji Yoshioka, Taizo Hibi, Junichi Shindoh, Shin Nakahira, Shigetoshi Yamada, Hideyuki Kanemoto, Takehisa Yazawa, Kenji Suzuki, Naohiro Sata, Yutaka Takeda, Shinji Norimizu, Koji Asai, Masakazu Yamamoto, Joe Matsumoto, Naoki Matsumura, Naoyuki Toyota, Masayuki Nozawa, Yuichi Nagakawa, Yasuhisa Mori, Yoichi Kawano, Takeyuki Misawa, Tadahiro Takada, Itaru Endo, Daigo Hata, Yusuke Watanabe, Masahiro Ito, Yoshiharu Nakamura, Yuki Honma, Tetsuji Ohyama, Takeshi Gocho, Yukio Asano, Atsushi Kohga, Masanao Kurata, Tadafumi Asaoka, Shuichi Fujioka |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Hepatology business.industry Bile duct General surgery Cholecystitis Acute medicine.anatomical_structure Cholecystectomy Laparoscopic medicine Acute cholecystitis Humans Surgery CLIPS Grading (education) business Laparoscopic cholecystectomy computer computer.programming_language |
| Zdroj: | Journal of hepato-biliary-pancreatic sciencesREFERENCES. 29(7) |
| ISSN: | 1868-6982 |
| Popis: | BACKGROUND Prevention of bile duct injury and vasculo-biliary injury while performing laparoscopic cholecystectomy (LC) is an unsolved problem. Clarifying the surgical difficulty using intraoperative findings can greatly contribute to the pursuit of best practices for acute cholecystitis. In this study, multiple evaluators assessed surgical difficulty items in unedited videos and then constructed a proposed surgical difficulty grading. METHODS We previously assembled a library of typical video clips of the intraoperative findings for all LC surgical difficulty items in acute cholecystitis. Fifty-one experts on LC assessed unedited surgical videos. Inter-rater agreement was assessed by Fleiss's κ and Gwet's agreement coefficient (AC). RESULTS Except for one item ("edematous change"), κ or AC exceeded 0.5, so the typical videos were judged to be applicable. The conceivable surgical difficulty gradings were analyzed. According to the assessment of difficulty factors, we created a surgical difficulty grading system (agreement probability = 0.923, κ = 0.712, 90% CI: 0.587-0.837; AC2 = 0.870, 90% CI: 0.768-0.972). CONCLUSION The previously published video clip library and our novel surgical difficulty grading system should serve as a universal objective tool to assess surgical difficulty in LC. |
| Databáze: | OpenAIRE |
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